The Ophthalmology Unit,  Universiti Malaysia Sarawak (UNIMAS), Kuching, Sarawak.
	The Ophthalmology Department, Sarawak General Hospital, Kuching, Sarawak, East Malaysia.

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Implant extrusion

Photo by Professor Chua Chung Nen

This 5 year-old girl was referred because of partial extrusion of the left orbital implant. She lost her sight from bilateral congenital primary open angle glaucoma. The left eye was eviscerated 3 years ago due to severe buphthalmos and an implant was inserted at the time. The appearance of the extruded content suggested that the implant was wrapped by mersilene mesh. Mersilene mesh was used to wrap the implant to encourage its integration as blood vessels tended to grow into the mesh. However, its use is associated with a higher incidence of implant extrusion.  

The acrylic ball and the mersilene mesh in this patient were removed to prevent infection. A new smaller acrylic ball was inserted.

Right phthisical eye with leukocoria. Left implant extrusion.

Close-up view of the partially extruded implant.

Typical appearance of mersilene mesh.

Close-up view of the exposed implant shows the conjunctiva has become integrated

with the mesilene mesh.

The mersile mesh was cut to release the implant. The mersile mesh was then

dissected from the sclera and conjunctiva.

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